Heart failure affects millions of people worldwide. Heart failure often manifests itself in relatively wide QRS signals, signifying a desynchronization between electrical activation of the right and left ventricles. Often, a left bundle branch block (LBBB) interrupts the normal conduction path to the left ventricle and results in the intrinsic conduction taking a relatively long time to reach the left ventricle, causing it to be activated well after the right ventricle. This dissynchrony results in a very inefficient contraction, resulting in very low cardiac output and patients who are unable to be very active. Over time, heart failure will progressively worsen and lead to death.
While some drug therapies may help some patients, electrical stimulation is more beneficial for those patients, assuming they meet certain criteria. Such stimulation is referred to as cardiac resynchronization therapy (CRT), which typically involves delivering electrical stimulation to the left ventricle prior to intrinsic conduction reaching the left ventricle, which results in a more synchronized contraction of the ventricles.
For patients who meet the current CRT implant criteria, a relatively large percentage (about 30%) of those patients do not respond to CRT therapy. What is needed is a system for increasing the likelihood that a patient will favorably respond to CRT therapy.
A new approach is proposed herein by using cardiac timing information to guide LV electrode selection and optionally lead placement for increasing the percentage of CRT responders.